VINCENT P FORTUNATO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****32

License Status

NOT RENEWED

Business

First Name

VINCENT P

Last Name

FORTUNATO

Suffix

Business Name

VINCENT P FORTUNATO MD

Original Issue Date

07/09/1987

Effective Date

07/09/1987

Expiration Date

07/31/1990

City

LAGRANGE

State

Zip

60525

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020